How some states are addressing doctor shortages

How some states are working to address a shortfall of primary care doctors:

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CALIFORNIA

A package of bills moving through the Legislature is aimed at addressing California's medical provider gap. The legislation would allow nurse practitioners, optometrists and pharmacists to expand the types of services they can provide patients. The proposals face heavy opposition from doctors, who favor training and placing more primary care physicians in rural and other underserved communities. Opponents also worry such changes would create two classes of medical care - one for people who have access to doctors and another for people who don't.

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DELAWARE

Among the steps Delaware officials have taken to address the primary care physician shortage is a loan repayment program for primary care providers who commit to work in underserved areas. The program, funded by the state and federal governments, provided more than $360,000 in loan repayments to seven primary care providers in fiscal 2013. Officials say they are looking at expanding it.

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FLORIDA

Gov. Rick Scott funded an additional 700 residency slots this year, but Florida will still need additional residencies and fellowships just to bring the state up to the national average per capita. Scott also recently signed into law a long-debated bill that expands the drug-prescribing powers of optometrists. The state now allows optometrists to prescribe oral medications to treat eye diseases. House Republicans repeatedly used the shortage of primary care physicians and nurses in the state as a reason not to expand Medicaid under the federal Affordable Care Act.

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ILLINOIS

A state medical society succeeded in killing or gutting bills this year that would have given more medical decision-making authority to psychologists, dentists and advanced-practice nurses. That included one bill that would have allowed trained dentists to give flu shots and other immunizations. The dental society plans to bring the issue to lawmakers again but focus narrowly on flu shots. The group contends dentists should be prepared to respond to a future flu pandemic. They plan to make the case that the Affordable Care Act will increase the number of patients eligible for free flu shots and that the number of professionals who can give them also should increase.

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INDIANA

State officials and professional associations representing primary care physicians and other health providers are reviewing the state's primary care providers and where they are concentrated. Shortly after the federal health care law was signed in 2010, state officials determined that Indiana had not been properly tracking the density of primary care physicians and needed to do a complete review, said David Roos, executive director of Covering Kids and Families of Indiana.

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KANSAS

Efforts in Kansas to address medically underserved areas of the state began nearly a half-century ago at the University of Kansas, where a scholarship program is aimed at recruiting new physicians to start their practices in rural areas. Kansas has expanded those efforts in recent budget years, including legislation this year to increase the scope of study that would be eligible for the scholarships in return for serving in rural areas. Legislators also have expanded the laws to give pharmacists the ability to perform certain wellness functions, including administering vaccines.